Division of Nephrology, Department of Medicine and Geriatrics, Princess Margaret HospitalHong Kong, China.
Nephrology (Carlton). 2011 Jan;16(1):57-62. doi: 10.1111/j.1440-1797.2010.01371.x.
Nocturnal home haemodialysis (NHHD) was started in Hong Kong in 2006. The experience of 1 year of NHHD with an alternate night schedule in two local centres is reported.
The clinical parameters of 14 patients who had completed 1 year of NHHD were retrospectively analyzed. All patients were receiving an alternate night schedule (3.5 sessions/week) for 6-8 h/session.
After 1 year of NHHD, haemoglobin levels increased from 9.6±1.6 g/dL before NHHD to 11.4±2.2 g/dL (P<0.05) despite a reduction in erythropoietin dose requirement from 120.6±44.3 to 59.4±74.6 U/kg/week (P<0.05). Four patients (29%) were able to stop taking erythropoietin after NHHD. Serum phosphate levels reduced from 2.33±0.41 to 1.59±0.29 mmol/L (P<0.01) and calcium phosphate product decreased from 5.29±0.96 to 3.74±0.90 mmol2/L2 (P<0.01). Phosphate binder dose was greatly reduced and eight patients (67%) were able to stop taking phosphate binders. The number of antihypertensive medications tended to reduced from 2.5±1.3 to 1.6±1.5 (P=0.067) with four patients (29%) able to stop antihypertensives. Left ventricular mass index decreased from 186±62 to 168±60 g/m2 (P=0.463) although this was not statistically significant. Weekly spKt/V during conventional haemodialysis was 3.63±0.95 while that during NHHD was three times higher at 11.09±6.44 (P<0.01). The quality of life indexes also showed improvement.
This 1 year experience of alternate night NHHD demonstrates benefits in terms of anaemia control, erythropoietin requirement, serum phosphate and calcium phosphate product reduction, blood pressure control, haemodialysis adequacy and quality of life. NHHD with an alternate night schedule is a promising dialytic therapy for patients receiving chronic haemodialysis in this locality.
香港自 2006 年开始开展夜间家庭血液透析（NHHD）。本研究报告了在当地 2 个中心开展为期 1 年的 NHHD 经验，采用隔日夜间治疗方案。
回顾性分析了 14 例完成 NHHD 治疗 1 年的患者的临床参数。所有患者均接受隔日夜间治疗方案（每周 3.5 次，每次 6-8 小时）。
NHHD 治疗 1 年后，血红蛋白水平从 NHHD 前的 9.6±1.6 g/dL 升高至 11.4±2.2 g/dL（P<0.05），尽管促红细胞生成素剂量需求从 120.6±44.3 降至 59.4±74.6 U/kg/周（P<0.05）。4 例（29%）患者在 NHHD 后能够停止使用促红细胞生成素。血清磷酸盐水平从 2.33±0.41 mmol/L 降至 1.59±0.29 mmol/L（P<0.01），钙磷乘积从 5.29±0.96 mmol2/L2 降至 3.74±0.90 mmol2/L2（P<0.01）。磷酸盐结合剂剂量显著减少，8 例（67%）患者能够停止使用磷酸盐结合剂。降压药物的数量从 2.5±1.3 种减少至 1.6±1.5 种（P=0.067），4 例（29%）患者能够停止使用降压药。左心室质量指数从 186±62 g/m2 降至 168±60 g/m2（P=0.463），尽管这无统计学意义。常规血液透析时每周 spKt/V 为 3.63±0.95，而 NHHD 时则增加了 3 倍，达到 11.09±6.44（P<0.01）。生活质量指标也有所改善。
本研究为期 1 年的隔日夜间 NHHD 经验表明，该治疗方案在控制贫血、促红细胞生成素需求、血清磷酸盐和钙磷乘积、血压控制、血液透析充分性和生活质量方面具有优势。隔日夜间 NHHD 是本地区接受慢性血液透析患者有前途的透析治疗方法。
